Jonathan Howell Rutherford, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

260129 Issued in AZ

Practice address

155 Calle Portal Ste 300
Sierra Vista, AZ 85635-2900

Phone

(520) 459-3011

Fax

(520) 364-4261

NPI assigned

Sep 14, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chiricahua Community Health Centers IncGroup PAC ID 5395638878, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonathan.rutherford.p1@direct.cchci.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1942241443

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Sierra Vista, AZ
  • NPI 1821309089

  Single Specialty

  NPD
• Chiricahua Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Willcox, AZ
  • NPI 1285488866
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1154091932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-6852",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CALLE PORTAL STE 300",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352900",
            "telephone_number": "520-459-3011",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "JONATHAN",
        "middle_name": "HOWELL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "260129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106788",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Rowser, OTR L
• Andrea P Ruble, RN, FNP-BC
• Casi Ellis Ruffo, ED.D.
• Chelsey NA Ruiz, FNP
• Russell K. Hanes DDS, PC
• Vivian Ryu, LCSW
• Radwan Saba, MD
• Saguaro Podiatry Associates PLLC
• Vivian Salgado, NP
• San Pedro Anesthesia, PLLC

• Psychiatric/Mental Health Nurse Practitioner in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.